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Apr 22, 2019 - Jul 6, 2020 - Refer to Subchapter 6 of the Dental Manual for prior authorization requirements. Note: MassHealth will not process 837D transactions or ADA claim forms with (2) is enrolled with the MassHealth agency as a hospital-licensed health center. professional under the direction of a physician or dentist for the provision of outpatient See Subchapter 6 of the Acute Outpatient Manual for service code. Jump to Subchapter 6: Dental Service Codes The MassHealth agency requires prior authorization for the following: (1) those services listed in Subchapter 6 of the Dental Manual with the abbreviation "PA" or Jul 6, 2020 - MassHealth Dental regulations are set forth in 130 CMR 420.000, available at and Subchapter 6 - Dental Service Codes and Descriptions, available at MassHealth Dental regulations are set forth in 130 CMR 420.000, available at and Subchapter 6 - Dental Service Codes and Descriptions, available at is eligible to provide services designated as dental clinic services in Subchapter 6 of the MassHealth Dental Manual for providers under 130 CMR 420.000.